Introduction
A Breast Lift, or Mastopexy, can restore a chest to a more feminine and natural position, solving cosmetic insecurities and resolving mental fatigue or frustration. In most cases, the Breast Lift procedure repositions the nipple and areola placement to enhance the new contoured appearance.
Normally, there are four problems associated with breast droop or ptosis. The breast tissue hangs on the chest wall, the nipples are normally below the inframammary fold, the areola is too large, and there is no fullness in the upper quadrant. Mastopexy alone can correct the first three, but an implant is required to get the desired fullness in the upper quadrant. A well-known system for defining breast ptosis is:
The standard mastopexy, with or without implants, will excellently correct breast ptosis. There is a vertical scar from the areola down to the inframammary fold and a horizontal scar in that fold. In a breast ptosis surgery, as in all cosmetic surgeries, it does not matter how much you take away but the appearance of what you leave is what counts. A number of permanent internal sutures are used on the breast to take the tension off the skin closure, because the less the tension on the skin, the finer the scar. Unfortunately, some people get a bad scar no matter what the surgeon does, due to their genetic predisposition. The good news is that most people do not have this genetic predisposition to scarring. Taping the breast scar post-operatively decreases the thickness of the scar, the redness of the scar, and the length of time until the scar is mature.
Dual plane mastopexy, or internal mastopexy, is when an implant is placed in the sub-pectoral space, but the release is done in the plane between the nipple and the pectoralis muscle, then a large piece of sticky plastic is connected to the skin, pulling the nipple and skin upward for three weeks securing a higher position of the breast tissue and the nipple while the implant in the subpectoral pocket stays at the inframammary line.
Large breast implants, by themselves, cause a correction in some minimal or zero-degree ptosis just because the volume of the implant causes the nipple to move up along an arc created by the anterior projection of the breast implant away from the chest wall. Then the high-profile implants that exist today give the best change of correction of minimal ptosis using only a breast implant.
The Benelli Mastopexy or circumareolar mastopexy is a technique invented by Dr. Louis Benelli of Paris, France. Dr. Schlesinger had the privilege of lecturing with Dr. Benelli for 12 years on the Mainland and even won an award for the best video in plastic surgery for his scientific presentation on the Benelli mastopexy (streaming video). The Benelli mastopexy can be done with or without implants, leaving the incision only at the edge of the areola, making it good for a minimal or moderate ptosis.
A unique breast lift invented by Dr. Schlesinger falls between a breast reduction and a breast augmentation called the Suction Reduction Augmentation Lift. While it is not for every breast, nor every patient, in the surgery a ¼” hidden incision, a suction breast reduction where all the fat and much of the glandular tissue is removed by liposuction, very similar to the technique used for male gynecomastia. It takes about six months for this suction reduction to get to the point where the breast can be augmented. During that time, the areola gets smaller with the weight of the breast tissue, and the breast and nipple move up, often significantly, therefore correcting the first three problems in the ptotic or droopy breast. Of course, the patient has to put up with smaller breasts for about six months, but then a transaxillary, sub-pectoral breast augmentation with dual plane mastopexy can be done, giving a beautiful lift with the smaller areola, the breast no longer hanging on the chest wall, and fullness in the upper quadrant along with minimal to no scarring as the suction incision and armpit incision are so small and well hidden that this becomes almost a scarless lift augmentation. As mentioned earlier, this lift is not for every breast and not for every patient, but it is a great variation for the right breast and the right person.
While some patients may only want to address breast sagging without increasing breast size, Dr. Schlesinger typically recommends a breast lift with augmentation to most of his patients, for a few key reasons:
Most patients are happiest with their outcome if they choose to have a breast lift with augmentation. To achieve optimal results and reduce visible scarring, the breast lift procedure is performed first, followed by the placement of implants two to three months after. This gives your tissues time to recover and allows me to determine which type, style, and size implants will work best with your lifted breasts.
The best candidates for a Breast Lift in Hawaii are those with the following characteristics:
First Steps
The first step to getting a Breast Lift in Hawaii with Dr. Schlesinger is to book a consultation. When you come into his office, you will be able to ask any questions or address any concerns you may have. Dr. Schlesinger will also evaluate your breasts and body type, as well as ask you questions about your medical history, lifestyle, and expectations. and how or which technique can work best for you. Once the two of you agree on the details, a personalized surgical plan will be created for you and our Patient Coordinator will help your schedule your surgical date.
On the day of your Breast Lift, Dr. Schlesinger will do his best to make your experience as comfortable as possible. Based on your breast’s style and the procedure’s goals, there could be many variations in the technique used, as mentioned above. Dr. Schlesinger typically performs his Breast Lifts using a local anesthetic, but could also be done with general anesthesia or intravenous sedation, depending on what is discussed during your consultation.
When it comes to the actual procedure, every detail is taken into account. First, Dr. Schlesinger will make a circular incision around the areola, with a second incision being made under the nipple and continuing to the bottom of the breast. A final incision is made along the breast crease at the base of the breast. These incisions define the areas where excess skin from aging or sagging of the breast can be removed. A small, thin tube (cannula) may be temporarily placed under the skin to drain any excess blood or fluid that may collect. Once the excess skin has been removed, the nipple and areola will be placed in a new position, and the breast will be reshaped about them, completing your new chest and look.
The entire surgery will take between three and five hours to complete.
After your surgery, you will be able to return home to recover comfortably and in peace. You should have a friend or family member available to take you home and be able to care for you for a day or so until you feel comfortable performing basic tasks that won’t be too strenuous. You recover much quicker from a lift than from a subpectoral augmentation. The time of breast lift recovery will not add to your recovery time for a subpectoral breast augmentation. Most patients can return to work within five to seven days post-operation.
What is the cost?
Costs for breast lift surgery with Dr. Schlesinger range from $11,000 to $14,000 without implants, and from $15,000 to $18,000 for a breast lift with implants.
This includes surgeon’s fees, operating room and lab costs, your breast implants (if applicable), post-op materials and garments, and laser scar revision, tattooing, and/or touch-ups, should you need them (most surgeons do not include touch-ups in their fee). Anesthesia fees, medication, and travel costs are not included.
Be sure to check out our patient financing options and current specials to see how you can save.
With more than 30 years of plastic surgery experience in Hawaii, S. Larry Schlesinger, MD, FACS, has performed more than 20,000 plastic surgery procedures. After taking his premedical studies at the University of Michigan, he continued his medical studies at the Medical College of Virginia, where he was the highest honor graduate. As a proud member of the American Society for Aesthetic Plastic Surgery, Dr. Schlesinger does not believe the surgery ends when the patient leaves the operating room and that the surgeon is responsible to assist the patient in getting the best conceivable scar post-operatively.
You don’t need to deal with the physical and mental discomforts of sagging breasts or the pain that comes with them. It all starts with a consultation, and our skilled team is here to make it a reality! Schedule a consultation with Hawaii’s Breast Lift specialist Dr. S. Larry Schlesinger, FACS by calling us today at (808) 597-8835, or request a consultation through our website, and a member of our team members will be in touch with you.
